Naike Bochatay1, Nadia M Bajwa, Stéphane Cullati, Virginie Muller-Juge, Katherine S Blondon, Noëlle Junod Perron, Fabienne Maître, Pierre Chopard, Nu Viet Vu, Sara Kim, Georges L Savoldelli, Patricia Hudelson, Mathieu R Nendaz. 1. N. Bochatay is a research assistant, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, and PhD candidate, Institute of Sociological Research, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-6098-4262. N.M. Bajwa is residency program director, Department of General Pediatrics, Children's Hospital, University Hospitals of Geneva, and faculty member, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-1445-4594. S. Cullati is a medical sociologist, Quality of Care Unit, Medical Directorate, University Hospitals of Geneva, and Institute of Sociological Research, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-3881-446X. V. Muller-Juge is a scientific collaborator, Unit of Primary Care (UIGP), Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-2346-8904. K.S. Blondon is junior faculty, Medical Directorate, University Hospitals of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-9407-8516. N. Junod Perron is coordinator, Institute of Primary Care, University Hospitals of Geneva, and faculty member, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-9124-8663. F. Maître is quality officer, Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland. P. Chopard is director, Quality of Care Unit, Medical Directorate, University Hospitals of Geneva, Geneva, Switzerland. N.V. Vu is emeritus professor, Faculty of Medicine, University of Geneva, Geneva, Switzerland. S. Kim is research professor, Department of Surgery, School of Medicine, University of Washington, Seattle, Washington. G.L. Savoldelli is associate professor and attending physician, Division of Anesthesiology, University Hospitals of Geneva, and Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-8968-6920. P. Hudelson is a medical anthropologist, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland. M.R. Nendaz is full professor and director, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, and attending physician, Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0003-3795-3254.
Abstract
PURPOSE: Without a proper understanding of conflict between health care professionals, designing effective conflict management training programs for trainees that reflect the complexity of the clinical working environment is difficult. To better inform the development of conflict management training, this study sought to explore health care professionals' experiences of conflicts and their characteristics. METHOD: Between 2014 and early 2016, 82 semistructured interviews were conducted with health care professionals directly involved in first-line patient care in four departments of the University Hospitals of Geneva. These professionals included residents, fellows, certified nursing assistants, nurses, and nurse supervisors. All interviews were transcribed verbatim, and conventional content analysis was used to derive conflict characteristics. RESULTS: Six conflict sources were identified. Among these sources, disagreements on patient care tended to be the primary trigger of conflict, whereas sources related to communication contributed to conflict escalation without directly triggering conflict. A framework of workplace conflict that integrates its multidimensional and cyclical nature was subsequently developed. This framework suggests that conflict consequences and responses are interrelated, and might generate further tensions that could affect health care professionals, teams, and organizations, as well as patient care. Findings also indicated that supervisors' responses to contentious situations often failed to meet health care professionals' expectations. CONCLUSIONS: Understanding conflicts between health care professionals involves several interrelated dimensions, such as sources, consequences, and responses to conflict. There is a need to strengthen health care professionals' ability to identify and respond to conflict and to further develop conflict management programs for clinical supervisors.
PURPOSE: Without a proper understanding of conflict between health care professionals, designing effective conflict management training programs for trainees that reflect the complexity of the clinical working environment is difficult. To better inform the development of conflict management training, this study sought to explore health care professionals' experiences of conflicts and their characteristics. METHOD: Between 2014 and early 2016, 82 semistructured interviews were conducted with health care professionals directly involved in first-line patient care in four departments of the University Hospitals of Geneva. These professionals included residents, fellows, certified nursing assistants, nurses, and nurse supervisors. All interviews were transcribed verbatim, and conventional content analysis was used to derive conflict characteristics. RESULTS: Six conflict sources were identified. Among these sources, disagreements on patient care tended to be the primary trigger of conflict, whereas sources related to communication contributed to conflict escalation without directly triggering conflict. A framework of workplace conflict that integrates its multidimensional and cyclical nature was subsequently developed. This framework suggests that conflict consequences and responses are interrelated, and might generate further tensions that could affect health care professionals, teams, and organizations, as well as patient care. Findings also indicated that supervisors' responses to contentious situations often failed to meet health care professionals' expectations. CONCLUSIONS: Understanding conflicts between health care professionals involves several interrelated dimensions, such as sources, consequences, and responses to conflict. There is a need to strengthen health care professionals' ability to identify and respond to conflict and to further develop conflict management programs for clinical supervisors.
Authors: Stéphane Cullati; Naike Bochatay; Fabienne Maître; Thierry Laroche; Virginie Muller-Juge; Katherine S Blondon; Noëlle Junod Perron; Nadia M Bajwa; Nu Viet Vu; Sara Kim; Georges L Savoldelli; Patricia Hudelson; Pierre Chopard; Mathieu R Nendaz Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2019-02-26
Authors: José Antonio Lozano-Lozano; Salvador Chacón-Moscoso; Susana Sanduvete-Chaves; Francisco Pablo Holgado-Tello Journal: Int J Environ Res Public Health Date: 2021-06-16 Impact factor: 3.390
Authors: Stéphane Cullati; Patricia Hudelson; Bara Ricou; Mathieu Nendaz; Thomas V Perneger; Monica Escher Journal: BMC Health Serv Res Date: 2018-08-08 Impact factor: 2.655